Sternal osteomyelitis has a low incidence, especially hematogenous osteomyelitis is very rare, and is a very difficult disease to treat in the field of orthopedics. It is commonly seen in postoperative sternal infections, in the elderly and in patients with systemic diseases combined with diabetes mellitus. The clinical presentation is characterized by multiple sinus tracts and, in severe cases, signs of infectious toxicity. Thorough debridement, unobstructed drainage, and establishment of local blood supply are the keys to successful treatment. Etiology: Sternal osteomyelitis is commonly seen as a complication of infection after transverse sternal and median sternal incision surgery, and is particularly common in elderly patients or those with systemic diseases such as combined diabetes. Clinical manifestations: Sternal infection after sternal surgery and long-term untreated traumatic sinus tracts can form multiple sinus tracts when located under the sternum or in the rib arch. In severe cases, systemic infectious toxic manifestations may occur. Examination: X-ray examination can be seen as sternal bone destruction and other bone marrow sternal osteomyelitis manifestations, and sinus tractography examination can understand the depth and scope of sinus tracts. Diagnosis: Based on the patient’s history of sternal surgery, postoperative incisional sinus tract formation and long-term failure to heal, combined with X-ray examination can be a clear diagnosis. Treatment: Sternal osteomyelitis occurs and often does not heal for a long time due to poor drainage, and local incision, scratching and drainage are ineffective. Thorough debridement, unobstructed drainage, and establishment of local blood supply are the keys to successful treatment. Clinically, closed continuous irrigation and post-clearing flap graft repair are mostly used.